Category

2018 Grand Prix: Responsible SME of the Year

Award for Pioneering Small and Medium-sized Companies that have Embedded Responsibility Across their Businesses and Engage in Several Major Areas of CSR.

What should nomination be about: This is not an award for a specific initiative or a single area. This category is designed to acknowledge small and medium-sized companies that can best demonstrate a company-wide commitment to Corporate Social Responsibility and have implemented CSR projects or programs with sustainable results in several appropriate areas of operations.

The award would be conferred to Georgian SME1 for outstanding CSR approach and most efficient activities performed in at least two out of the following four areas:

Responsibility towards the environment Responsibility towards employees Responsibility in the marketplace. Responsibility towards the community

Please be noted: the assessment for this category is two-round. The shortlisted candidates would be invited to the personal presentation before the jury.

ENTRY FORMCompany Name

If successful, we will use the company name as written here on any award materials (certificates, press releases), so please ensure you write your company name and nomination title in full how you would like it published.

CONTACT DETAILS

Main contact person

This person will be the main point of contact for all correspondence, enquiries or updates concerning your submissionFull Name:Position:

1 According to National Statistics office of Georgia (http://www.geostat.ge ) a SME is defined as a company whose number of employees does not exceed 250.

Category

2018 Grand Prix: Responsible SME of the Year

Telephone number:Mobile number:Email:

Secondary contactPlease let us know whom we can address concerning the entry in your absenceFull Name:Position:Telephone:Mobile:Email:

If your contact information changes after submitting an application, it is your responsibility to amend your details with Contest Organizers.

SECTION I - COMPANY DETAILS This section is not scored but provides assessors with a good understanding of the overall business of the company in a wider context and its impact on society. Application forms missing this information will not be accepted.

Date of foundation of the company

We are a subsidiary, partner or supplier of a foreign/global company? If yes, please specify

□ YES □ NO

If yes, indicate the name of this foreign/global company and year of beginning of operations in Georgia

Company Address

Legal form

Full name and job title of company Chief Executive (or equivalent)

Number of employees (approximately)

Annual turnover □ Less than 1 million GEL□ From 1 million up to 12 million GEL□ From 12 million up to 60 million GEL□ More than 60 million Gel

The primary brands, products, and services

Geographic coverage

Does your company have a statement of the company’s mission & values (please

□ Yes □ No

Category

2018 Grand Prix: Responsible SME of the Year

indicate URL if relevant)

Does your company have a code of ethics? (please indicate URL if relevant)

□ Yes □ No

Does your company publish annual financial reports? (please indicate URL of the most recent one, if relevant)

□ Yes □ No

If in 2017-2018 your company published sustainability /CSR report please indicate URLs

Who is responsible for coordination of CSR activities in the organization - there is a CSR coordinator; CSR activities are coordinated by PR manager/Marketing manager/HR manager, other (please specify)

Please indicate, if your company is a member of any local or international network aimed at CSR promotion, e.g. Global Compact, CSR Club, AmCham CSR Committee, Georgian Pro Bono Network etc. (please list all)

Company webpage

Official Facebook/LinkedIn page

Twitter handle (if any) @

Company logo: please submit a high-resolution version of company’s business logo – upload logo on the google drive and share the link here:

Fill in the box:

Quotation of the CEO or equivalentPlease provide a quote from your CEO (or equivalent) why responsible business is important for the nominated company and for him/her personally (max. 100 words).

This point is not obligatory; however, it is very much appreciated to help assessors understand the support provided from the top of the organization. If submitted, quotation could be published in various award materials (such as web-page, information brochures etc.)

Fill in the box:

Category

2018 Grand Prix: Responsible SME of the Year

N.B make sure you get in your request for this early on in the process to accommodate your CEO’s (or equivalent) diary/ sign off process.

End of non-scored section.

SECTION II

Description of your policies, practices and results achieved in main areas of CSRThis is a scored section. In this section you have to provide: a) brief description of company’s general CSR approach and strategy; b) brief description of the company’s approach, practices/activities and results achieved for any two out of the four main areas of CSR.

For each of the three selected sphere company would be assessed according to following 3 aspects: approach to the selected area, management and communication; activities implemented; results achieved.

a) Company’s general CSR approach and strategy(300 words max. Weight - 10% of total score)Please describe your general approach to CSR. What areas do you focus on and why? What are main values and ethical principles of your company and how do you ensure their implementation? How CSR activities are managed within company? How do you communicate with your employees or external stakeholders about your CSR policy and activities?

Fill in the box:

b) Company’s approach, performance and results in selected CSR areas(Weight - 90% of total score)Please select any two out of the four main areas of responsible business conduct and fill the appropriate tables below. For each selected area maximus score would be 45% of the total score. If you also can provide at least some minor information about the fourth are as well, please do it, this would be considered as an additional bonus by judges.

Category

2018 Grand Prix: Responsible SME of the Year

Environmental Responsibility(500 words max.)

Describe the company's overall environmental policy/approach. Which topics do you focus on and why?Please mention, if you have any management systems to track and monitor your environmental impacts. How do you communicate with stakeholders on environmental issues?

What do you do beyond legal requirements to reduce your environmental impacts? Briefly describe programs/projects/initiatives in the field of environmental protection you have implemented in 2017-2018 (examples could be: energy efficiency and material saving measures, water management, support for sustainable transport solutions, waste management, green product design, protection of biodiversity, initiatives aimed at environmental behavior change, raising environmental awareness etc.

Describe results achieved and impact it had on the target groups; quantify, where feasible. Describe what are your future plans and what are you doing to ensure sustainability of your results.

Responsibility Towards Employees(500 words max.)

Please explain your approach to employee well-being: which topics do you focus on? How do you communicate with your employees and identify their needs? Do you have mechanism for considering employee feedback? Do you have a professional human resource management system in place?

Briefly describe what did you do (initiatives, activities, programs) above legal requirements to ensure

Category

2018 Grand Prix: Responsible SME of the Year

physical, mental and social well-being of your employees in 2017-2018? (this could cover issues like: professional development and education; social protection and bonuses; health and safety; ensuring equal opportunities with regard to gender, age, disabilities, ethnicity etc.; work-life balance; good work climate and employee volunteering etc.)

Describe results achieved in 2017-2018 and impact it has had on both employees and the business; quantify, where feasible. Demonstrate your ambition and plans for the future.

Responsibility in the Marketplace(500 words max.)

Please describe your approach with regard to customer/client- related issues, suppliers, product safety, transparency and personal data protection. Which topics do you focus on and why? Do you have management systems in place to deal with customer or supplier complaints? Safety of your products/services? How do you communicate with your customers, clients and suppliers?

Describe what do you offer customers beyond the law? Do you offer responsible/innovative products or services to customers with disabilities or other vulnerable groups? Briefly describe programs/projects/initiatives you have implemented in this sphere in 2017-2018.

Describe results/improvements achieved and impact it has had on both target groups and the business; quantify, where feasible. Demonstrate your ambition and plans for the future.

Supporting Communities

Category

2018 Grand Prix: Responsible SME of the Year

(500 words max.)

Describe you company’s approach towards community support? what specific issues or target groups you concentrate your efforts on and why?

How do you communicate with community members? Do you have mechanism for considering community complaints and considerations?

Briefly describe programs, projects, initiatives, aimed at supporting and developing communities implemented in 2017-2018. Specify, what problems are you trying to address, what approaches did you use (financial support, in-kind contribution, employee volunteering; campaigns etc.);

If you implemented any of above initiatives in partnership with other organization, please briefly specify goals and results of this partnership.

Describe results achieved in 2017-2018 and impact it has on target groups/target problem; quantify, where feasible. Describe, what did you do for the sustainability of the results, what are your plans for the future?

Please note: You do not have to provide equally detailed answers to all above questions to submit an

entry. Provide as much information as available.

You are welcome to include in the above sections information about other factors which, in your opinion, may influence decision of the Jury.

When completing your entry, please refer also to the Evaluation Scoring Guide, available at: www.meiora.ge

Section IV - Links and evidence (optional)

Category

2018 Grand Prix: Responsible SME of the Year

This part is not obligatory, however submitting evidence and proofs for your project will help the Jury to properly asses your entry and increases the chances of winning. Please submit any materials about the project that you have (documents, photos, videos, url) to illustrate the content of your nomination and results achieved. All file types are accepted only as a soft copy.

When providing photos, please provide high resolution photos; When providing the extensive documents, please indicate exact pages that you would like the Jury to pay attention to; You can also include relevant URL links to supporting evidence in the main text of the Entry, next to the point the evidence supports.

Please be as specific about page number of the submitted attachment or video timeframe as possible. Jury will not be able to read full extensive documents, so it is important to signpost the most relevant aspects of any evidence provided.

Please upload all your supporting materials on google drive, bound in a package/folder and share the link:

Fill in the box:

Final Statements

Confidentiality

Let us know here if you would like some aspects of your entry kept confidential

□ I do not want to keep any aspect of my entry confidential

□ Please keep confidential following parts of my entry ________________________________________

Mandatory requirements:

The company has not been legally convicted in the past three years in connection with its business activities.

The activities described in the nomination comply with the legislative requirements of Georgia.

Cases:If the company has been linked with some scandals for the past three years (2016-2018), please describe it in no more than 300 words and comment the position of the company (Evaluators often have critical information about business cases from the media, and the Nominated Companies also have the opportunity to present their views so the Jury can judge the nomination objectively):

Fill in the box:

Category

2018 Grand Prix: Responsible SME of the Year

DECLARATION OF THE COMPANY

(Please attach to your submission the scanned Declaration of the Company signed by Chief Executive (or equivalent), or person responsible for the nomination)

Name of the company: _______________________________________________________________

We declare that all information contained in this application is accurate and fairly presented. We agree with nomination of the company for the Georgia’s Responsible Business Awards 2018. We agree to abide by the rules of the Awards, including the understanding that the Jury’s decision is final and that no correspondence will be entered into regarding their decision.

By entering the Awards, we agree to take part in publicity and promotion of the event. We also understand that our entry may attract media attention and we are willing to cooperate with the media to promote our organization, the Awards and the successes of responsible business in Georgia.

Entry authorized by:

Name of the CEO (or equivalent) /person responsible for the application: ________________________________________________________

Position: ________________________________________________

Date and signature: _______________________________________

(You can also download the Sample of the Declaration here)

DECLARATION OF PARTNER(If you mention a significant partnership with a different organization in the nomination, the affiliate confirms that the information is true.)

Name of the organization _______________________________________________________________We declare that there is a correct information about our partnership in the nomination presented by (name of the nominated company) _________________ We agree with the company's nomination for Georgia’s Responsible Business Awards 2018 for the category (category name) __________________

Name of the person representing partner

_______________________________________________________

Category

2018 Grand Prix: Responsible SME of the Year

Position: _______________________________________________

Phone number: _________________________________________

E-mail: ________________________________________________

Date and signature______________________________________

(You can download the sample of the Partner’s Declaration here)

Please be sure to complete all sections. Incomplete applications would not be considered

How to apply

Download the Entry form, fill it in and send us a completed form in word doc format along with the attachments to the following email: csrawards@meliora.ge no later than Friday, 5 October 2018, 18:00.

Please refer also to the Guidelines for the Applicants and Terms and Conditions for further supporting information.